What is an accurate Blood Pressure?

Everytime I go to the Doctor’s office I enter a Blood pressure quagmire. Years back I had a Dr who gave me samples and a prescription for Benicar. My pressure was sad to be 138/90. A home auto BP machine had me at 120/80. Day 3 on the Benicar and I bent over to pick something up and I almost went down feeling lightheaded. My pressure was really low on my machine but don’t remember the numbers.

I saw saw a different doctor. He checked my machine on me and pronounced it accurate. He had me take my pressure morning and night for 2 weeks and record the results. He reviewed the results and said I was fine. Then went on to tell me that he would never prescribe a dual agent BP Med based on my reported pressure, perhaps diet modification but not what I received.

A few weeks ago I went for a physical with an APRN and was told my pressure was 140/93. 45 minutes earlier I was in the gym finishing my deadlifts. Then after the physical was done they had me sit in a chair alone in the examination room for 5 min. My pressure was taken again this time it was what I see at home 110/70. But of course the paperwork I walked out with (my results) said my pressure was 140/93.

I had my pressure taken today in another doctor’s office, this time standing and again it came out as 140/90.

Undoubtedly I have some white coat syndrome going on. The mere fact that my blood pressure will be taken puts me on edge due to past experiences.

I guess my question is: if a known good machine records my pressure during the day at home between 110/70 - 120/80 for a 59 year old male who takes zero medications except eye drops for pressure issues should I be concerned about Doctor’s office readings?

White coat syndrome is quite common, but isn’t exactly as benign as we’ve historically thought: https://www.nejm.org/doi/full/10.1056/NEJMoa1712231

I would recommend asking your doctor/clinician for 24-hour ambulatory blood pressure monitoring (ABPM), as this will definitively “prove” what’s going on, and with that documentation on your chart you’ll have more evidence to tell future clinicians who may try to treat you overly aggressively.